Calabro Nathan, Henriksen Kammi, Lim Seah H, Kerns Eric
Clin Nephrol. 2018 Jun;89(6):469-473. doi: 10.5414/CN109344.
We report a case of glomerular basement membrane crescentic glomerulonephritis and multicentric Castleman disease-associated interstitial nephritis in a patient with human immunodeficiency virus (HIV) infection. The patient received corticosteroids, cyclophosphamide, and plasmapheresis, and within 3 weeks, there was worsening thrombocytopenia, anemia, and renal function requiring initiation of hemodialysis. He then received 8 weekly doses of rituximab, and there was steady improvement in renal function, such that he stopped dialysis within 6 weeks and has remained in disease remission at 1-year follow-up. This is the first case report of acute kidney injury caused by both antiglomerular basement membrane disease and multicentric Castleman disease, with a favorable response to rituximab. .
我们报告了一例人类免疫缺陷病毒(HIV)感染患者发生的肾小球基底膜新月体性肾小球肾炎和多中心Castleman病相关间质性肾炎。该患者接受了皮质类固醇、环磷酰胺和血浆置换治疗,3周内出现血小板减少、贫血加重以及肾功能恶化,需要开始血液透析。随后他接受了8周的利妥昔单抗治疗,肾功能稳步改善,以至于他在6周内停止了透析,并且在1年的随访中病情一直处于缓解状态。这是首例由抗肾小球基底膜病和多中心Castleman病共同导致急性肾损伤且对利妥昔单抗有良好反应的病例报告。